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Data show use of prescription monitor on rise

By Katie Lannan, State House News Service

Updated:
11/23/2016 11:01:43 AM EST

BOSTON -- Daily searches of the state's prescription monitoring program have more than quadrupled after an overhaul of the program this year and the introduction of a requirement that doctors must check the system before prescribing opioids with the highest risk of abuse.

On Oct. 15, a change in law requires prescribers to search the program -- called the Massachusetts Prescription Awareness Tool, or MassPAT -- before issuing a prescription for Schedule II or Schedule III narcotics, which are defined by the federal government as having a higher potential for abuse than other medications.

Since that date, prescribers have searched MassPAT an average of 28,423 times per weekday, according to data provided by the Department of Public Health. In July, prescribers searched the previous version of the prescription monitoring program an average of 5,942 times per weekday.

"Obviously, the ultimate goal is to decrease the number of opiate overdose deaths that we're seeing in Massachusetts, which is completely unacceptable," Public Health Commissioner Monica Bharel said. "But in the short run, we know the system is effective if people are using it."

The mandated use, a component of an addiction-prevention law Gov. Charlie Baker signed in March, is one of several strategies the state is taking as it seeks to combat climbing rates of opioid addiction and overdose.

Requirements to check prescription monitoring programs are a "relatively new" policy, according to the first Surgeon General's Report on Alcohol, Drugs and Health.

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The report, released last week, said data from some of the earliest states to institute such mandates -- Kentucky, Tennessee, New York and Ohio -- show "substantial increases in queries, reductions in opioid prescribing, and declines in multiple provider episodes (doctor shopping) following implementation."

The new version of the Massachusetts monitoring program launched on Aug. 22, with upgrades including a streamlined interface and compatibility with prescription data collected by other states. In the first week of the program, prescribers made an average of 12,016 searches per weekday, according to the DPH.

Doctors, dentists, midlevel practitioners and pharmacists who sign into MassPAT, and enter a patient's name and birthdate, receive a year's worth of clinical information, showing the drugs prescribed and information on the prescriber and pharmacy.

Bharel said MassPAT can now be used with prescription monitoring programs in more than 20 other states, making their data accessible to Massachusetts doctors.

Bharel said one of the department's goals is to connect MassPAT with all other states that have prescription monitoring programs.

Forty-nine states, the District of Columbia and Guam currently operate prescription-drug monitoring programs, with Missouri as the exception, according to the National Conference on State Legislatures. At least 26 states and Guam require prescribers to check the system before writing an opioid prescription.

Dr. James Gessner, president of the Massachusetts Medical Society, said doctors benefit from the access to information in other states, particularly those that are nearby.

"We have contiguous borders with New Hampshire and Vermont and New York, and when you're up in the Lowell area, Salem's right across the border, and I think a lot of residents in the southern part of New Hampshire probably get their health care where they grew up, just over the border in Lowell and Lawrence and Lahey Clinic, for example," Gessner said. "When the doctor's on the border, they're probably seeing patients from both states, so it's nice -- essential, really -- to be able to follow that."

Describing the transition to the new system as "fairly smooth," Gessner said MassPAT is easy to use and helps doctors get information on their patients quickly.

"I think everybody's breathing a sigh of relief," he said. "I think everything's working as advertised."

Dr. Raymond Martin, president of the Massachusetts Dental Society, called MassPAT "a big improvement" over the previous system, which he said was "pretty cumbersome." A general dentist who said he prescribes opioids less frequently than an oral surgeon might, Martin said one of the program's biggest advantages is its speed.

"Being able to do it easily, that's the biggest thing," he said. "Trying to do it between patients is pretty tough."

The number of prescriptions for Schedule II and III opioids declined in the third quarter of 2016, when compared to the same three-month period in 2015, according a Department of Public Health quarterly opioid report.

The report said there were 1,005 confirmed, unintentional opioid overdose deaths in Massachusetts in the first nine months of 2016, with an estimated additional 392 to 470 suspected opioid-related deaths.

Bharel said MassPAT is one piece of a "comprehensive response" to the opioid epidemic.

"It's going to be hard to tease out which pieces specifically are resulting in improvements, but we know it took us a while to get into this opioid epidemic, and it will take us a while and a really committed effort to get out of it," Bharel said.

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